Hormone Replacement Therapy Shows No Increased Cardiovascular Risk in Study of Over 52,000 Women

Could modern hormone replacement therapy be safer for women's hearts than previously believed? A large study involving more than 52,000 women suggests that contemporary hormone replacement therapy (HRT) is not associated with an increased risk of heart attack, stroke, blood clots or premature death when initiated around the time of menopause.

The preliminary findings are scheduled to be presented at the American Heart Association's Scientific Sessions 2026, taking place from November 6 to 9 in Chicago.

Researchers in Israel analysed health records from 52,330 women aged 45 to 59 years who had no previous history of cardiovascular disease, blood clots or cancer.

Half of the participants had started HRT to manage menopausal symptoms, while the remaining women had not received hormone therapy.

Researchers matched participants according to age, body mass index, blood pressure, cholesterol levels, diabetes status, smoking habits and socioeconomic characteristics.

The women were followed for an average of 12 years, with some health records covering up to 23 years.

The findings revealed that 4.4% of women receiving HRT experienced cardiovascular events, including heart attack or stroke, compared with 4.6% of women not receiving treatment.

Importantly, blood clots occurred in 0.33% of women in both groups, indicating no observed difference in risk.

Premature death before age 80 was recorded in 1.3% of HRT users compared with 1.2% of non-users.

Researchers also reported similar findings across different hormone therapy formulations and administration methods, including oral medication, patches and gels.

The results suggest that contemporary HRT may not increase cardiovascular risks among appropriately selected women beginning treatment during midlife.

However, the observational study could not establish cause and effect, and unmeasured lifestyle or clinical differences may have influenced the findings.

The research remains preliminary and has not yet undergone full peer review.

REFERENCE: Ronen Arbel, et al.; Long-term study finds modern hormone replacement therapy not linked to heart disease risk; American Heart Association Scientific Sessions 2026; https://newsroom.heart.org/news/long-term-study-finds-modern-hormone-replacement-therapy-not-linked-to-heart-disease-risk